EBMS continually is exploring innovative ways to improve the lives of our customers, focusing on the fiscal health of the organizations we serve, and the health and wellbeing of every single member.
Like you, EBMS has excelled in this ever-changing healthcare marketplace by establishing and maintaining a stellar reputation for integrity in all aspects of our business. We have strategically aligned our company with outstanding business partners like you, who share our same core values and focus on innovation. We are proud to have you as our partner as we work together to deliver better health outcomes for the clients we serve.
As a partner provider, you now have a dedicated team of EBMS specialists to support you. The team works closely with you to share data and to assist in the improvement of cost and quality of care. Other immediate benefits include:
- Assistance* with coordination for inpatient admission authorizations. Access CareLink’s NEW online precertification service today!
- Access to a UR nurse or case manager for questions related to patients’ hospital admission or plan of care authorizations
- Contracting assistance to join a group’s select PPO network
- 24/7 online access to patients’ eligibility, benefits and claims status
- Comprehensive reporting
- Ongoing maintenance of provider data to ensure timely, accurate payment
- NEW! ePayment options** for improved cash flow and reduction in administrative costs
* Providers, did you know you can now initiate the precertification process for Utilization Review through a secure website? CareLink partners with American Health to provide Utilization Management. As an enhancement to the program, CareLink now offers a secure website where providers can start the precertification process for your members at no additional cost. The precertification website is easy to use and collects all the information that needs to be provided for precertification in a step-by-step format. If more information is required to make a decision, the CareLink team at American Health reaches out to the provider within 24 hours to obtain it. Access CareLink’s precertification website at: careLink.mednecessity.com. Technical assistance for the CareLink/AHH precertification site is available at: 866.270.2244.
** EBMS has selected Pay-Plus Solutions as our ePayment vendor to assist us in quickly transferring payment as well as complying with PPACA Section 1104. To sign up for ePayments using ACH or Credit Card as well as electronic EOB’s (835, Excel, PDF) please visit www.ppsonline.com or email: email@example.com or call the Membership Services at 1-877-828-8834.
Time Sensitive Note to Providers:
ICD-10, Are you ready to submit your claims on October 1, 2015?
Any claims with dates of service October 1, 2015 and after must contain ICD-10 diagnosis and/or procedure codes, rather than ICD-9 codes. It is very important that you have contacted your vendor to ensure that your software can include these codes in your electronic claims. Additionally, services performed October 1, 2015 and after cannot be submitted on the same claim as services performed on or prior to September 30, 2015. These services must be split onto separate claims so the appropriate diagnosis coding method can be used. These rules also apply to claims submitted manually to EBMS.
For assistance with the cross walk between the current ICD-9 codes and the new ICD-10 codes, EBMS encourages you to review resources made available through CMS and Medicare administrators, AAPC and the Medical Billing Association.
Through EBMS’ partnership with Emdeon, HIPAA 5010 Eligibility (270/271)
and Claims Status (276/277) transactions are available for Providers!
Two easy ways to get started:
Contact your software vendor or clearinghouse. If available, 5010 transactions may be integrated into your Practice Management System or Hospital Information System. This allows systems to automatically generate an inquiry and/or to enable automatic posting of the benefit information to patient accounts. Many vendors and clearinghouses also offer multi-payer, web-based batch or real-time eligibility solutions.
Contact Emdeon at firstname.lastname@example.org or 866.369.8805 for more information. An Emdeon representative can discuss your facility’s needs, pricing and provide an application or help with online enrollment for the electronic access to eligibility and claims status.
- ICD-10: Are You Ready? Info for Providers
- HeW (complete, all payer EDI gateway and revenue cycle management solution)
- HeW Software (submit claims electronically to EBMS)
*If this is your first time submitting a claim, please call HeW at 877.565.5457 to set up an account.
- Pay-Plus® Secure Electronic Payment for Providers
- Pay-Plus® Secure Electronic Payment Info Video
- miBenefits Demo
- miHealthManager Demo
- Provider Network Listing
- Legal Update
- Legal Update - 6/6/13
- Healthcare Reform Timeline
- How I can participate in a Provider Network administered by EBMS
- Sample ID Card – Network Identification
- Creating Healthy Communities
- Explanation of Provider Remittance Summary (EOB)
- Access CareLink’s NEW Online Pre Certification Service
EBMS and partner Pay-Plus® Solutions are introducing new electronic payment processes to bring providers the latest in secure ePayment technology, adding speed and efficiency to our claims payment process. For additional information or questions, please contact the Pay-Plus® Customer Service Department at (877) 828-8770. Click here to read explanatory letter.